POS0597 PREDICTORS OF PERCEIVED RISK IN FIRST DEGREE RELATIVES OF RHEUMATOID ARTHRITIS PATIENTS
Authors: S. Bunnewell, I. Wells, D. Zemedikun, G. Simons, C. Mallen, K. Raza, M. Falahee
Journal: Annals of the Rheumatic Diseases (2022)

Background Risk of rheumatoid arthritis (RA) is 3-5 times higher in first-degree relatives (FDRs). Efforts are increasing to develop preventive interventions for this at risk group. Risk perception is a key predictor of health behaviours, including FDRs’ interest in predictive testing 1 and preventive intervention for RA. Effective risk communication is essential for RA prevention studies and clinical translation 2 . Objectives To define variables associated with perceived risk of developing RA in FDRs of RA patients. Methods RA patients attending outpatient clinics (West Midlands, UK) were asked to invite their FDRs to complete a cross-sectional printed survey. Patients were also invited to complete a survey. Unique survey numbers enabled linkage of FDR and proband responses. FDRs’ perceived absolute risk, comparative risk, experiential risk, and worry about risk were assessed using 5-point Likert scales. Predictor variables included demographics, the Single Item Literacy Screener, Brief Illness Perception Questionnaire, Brief Approach/Avoidance Coping Questionnaire, Life Orientation Test Revised and the Short Health Anxiety Inventory. Patient predictors of FDR perceived risk included demographics, time since RA diagnosis and Rheumatoid Arthritis Impact of Disease Score. Outcome measure responses were grouped into ‘low’ and ‘high’ for regression analyses. Univariable analysis used independent samples T-tests, chi-square tests and Mann-Whitney U Tests. Backwards stepwise binary logistic regression examined the relationship between FDR characteristics and perceived risk of RA. Generalised Estimating Equations assessed whether patient variables predicted FDR’s perceived risk. Results 396 FDRs returned a survey. Paired data from 213 patients were available for 292 of these FDRs. The distributions of risk perception scores are shown in Figure 1. All measures of perceived risk were inter-correlated (p&lt;0.001; ranging from r=0.48 to r=0.80). 65.2% of FDRs perceived themselves to be ‘Likely’ or ‘Very Likely’ to develop RA in their lifetime. FDR’s ethnic group, deprivation index, employment status, education level, smoking status, cohabitation with index patient status, coping style and dispositional optimism were not significantly different between high and low perceived risk groups. Characteristics significant in univariable analyses were used in multivariable analyses (Table 1). Children were 3.89 times more likely than siblings to perceive themselves at high risk of RA. Higher health anxiety scores were associated with increased perceived risk. Female gender, and beliefs that RA would last a long time, and cause higher concern and negative emotional impact predicted increased risk perceptions. Higher perceptions of how well treatment would control RA was associated with a reduced likelihood of perceiving oneself at high risk. Index patient characteristics did not associate with FDRs’ risk perceptions. Table 1. Multivariable analysis FDR Characteristic Perceived Risk [Odds Ratio (95% Confidence Interval)] Absolute Comparative Experiential Worry about Risk Gender 1.98 (1.19-3.27) * Male $ Female Relationship to index patient 2.80 (1.70-4.61) *** 3.43 (2.04-5.78) *** 3.89 (2.24-6.75) *** 2.26 (1.30-3.94) ** Child Sibling $ Health Literacy 1.50 (1.00-2.25) Illness Perceptions 0.89 (0.79-0.99) * 1.25 (1.05-1.48) * 1.17 (0.99-1.38) 0.84 (0.74-0.94) ** Timeline 0.91 (0.81-1.01) 0.87 (0.77-0.98) * 1.36 (1.13-1.63) ** Treatment control 1.20 (1.02-1.40) * Concern Emotion Health Anxiety 1.04 (1.01-1.07) * 1.05 (1.01-1.07) * 1.07 (1.03-1.11) ** 1.06 (1.02-1.09) ** * p &lt;0.05, ** p &lt;0.01, *** p &lt;0.001, $ Reference Conclusion FDRs’ perceived risk of RA was high. Key predictors included being a child of a patient with RA, higher health anxiety and lower perceptions of RA treatment control. An understanding of these predictors will inform the development of effective risk communication and preventive strategies. References [1]Wells et al. Rheumatology. 2021 doi: 10.1093/rheumatology/keab890 [2]Mankia et al. Ann Rheum Dis. 2021;80(10):1286-98 Acknowledgements S. Bunnewell and I. Wells are joint first authors. Disclosure of Interests None declared